Di Febo Gianfranco, Bedendo Attilio, Romano Federica, Cairo Francesco, Carnevale Gianfranco
Int J Prosthodont. 2015 May-Jun;28(3):246-51. doi: 10.11607/ijp.3995.
The aim of this long-term cohort study was to evaluate the efficacy and complications of fixed partial dentures in a convenience sample of 100 patients with periodontal disease who were treated and maintained periodontal patients after 20 years.
After active treatment, including periodontal surgery and endodontic and prosthetic treatment, patients were enrolled in a supportive periodontal care (SPC) program with 3- to 6-month recalls. All patients showed clinical data recorded at (1) the original consultation (T0), (2) the first SPC visit following the completion of prosthetic treatment (T1), and (3) at the latest SPC clinical session 20 years after T1 (T2). Multivariate analyses were performed to investigate the influence of clinical variables on the risk of prosthetic abutment (PA) loss after 20 years' visits.
The final sample comprised 100 patients. At T1, a total of 948 PAs represented the original sample of experimental teeth. At the 20-year follow-up, a total of 854 PAs (90.1%) were still in function, while 94 (9.9%) PAs in 41 patients (41%) were lost during SPC; 98% of lost PA were endodontically treated. Vertical root fracture (48%) was the major cause of PA loss, while progression of periodontitis caused 31% of PA loss. Age (P = .002), Full-Mouth Plaque Score (P < .0001), Full-Mouth Bleeding Score (P = .0002), and oral parafunctions (P = .0083) were associated with increased probability of PA failure. Among clinical-related factors, endodontic treatment (P = .0082), root resection/ amputation (P < .0001), multi-rooted teeth (P = .0005), and abutment associated with parafunction (P < .0001) were associated with increased risk of abutment loss after 20 years.
Perioprosthetic treatment in compliant patients is highly successful after 20 years of SPC.
这项长期队列研究的目的是评估在100例牙周病患者的便利样本中，固定局部义齿在经过20年治疗和维持牙周治疗后的疗效和并发症。
在包括牙周手术、牙髓治疗和修复治疗在内的积极治疗后，患者被纳入支持性牙周护理（SPC）计划，每3至6个月复诊一次。所有患者均有在以下时间点记录的临床数据：（1）初次就诊时（T0）；（2）修复治疗完成后的首次SPC就诊时（T1）；（3）T1后20年的最新SPC临床检查时（T2）。进行多变量分析以研究临床变量对20年随访后修复基牙（PA）丧失风险的影响。
最终样本包括100例患者。在T1时，共有948个PA代表实验牙的原始样本。在20年随访时，共有854个PA（90.1%）仍在发挥功能，而41例患者（41%）中的94个PA（9.9%）在SPC期间丧失；丧失的PA中有98%接受过牙髓治疗。垂直根折（48%）是PA丧失的主要原因，而牙周炎进展导致31%的PA丧失。年龄（P = 0.002）、全口菌斑评分（P < 0.0001）、全口出血评分（P = 0.0002）和口腔副功能（P = 0.0083）与PA失败概率增加相关。在临床相关因素中，牙髓治疗（P = 0.0082）、牙根切除术/截根术（P < 0.0001）、多根牙（P = 0.0005）以及与副功能相关的基牙（P < 0.0001）与20年后基牙丧失风险增加相关。
在进行20年的SPC后，依从性患者的牙周修复治疗非常成功。
